Polypoid lesions of the esophagus occur infrequently and may be benign or malignant. One malignant polypoid tumor, pseudosarcoma, appears to be a distinct pathological entity; the polypoid portion is composed of sarcomatous spindle cells and the base of the polyp shows in situ or invasive squamous cell carcinoma. A patient with this lesion is described and the 16 previously reported patients are reviewed. The results indicate that local resection is inadequate; radical esophagectomy is required for cure.